Abstract:
:The era prior to 1990 was a time of careful observation of disease presentation, course, outcomes and meticulous pathology studies. These mainly single-centre studies introduced new life-saving therapies for drugs still used effectively today. In the 1970-1980s, cyclophosphamide (CyP) added to glucocorticosteroids (GCS) was shown to be life-saving. The trade-off was often severe adverse events. Some forms of vasculitis were found not as ominous as thought initially. Some could be treated with safer drugs [e.g. methotrexate (MTX)]. However, whether mild or severe, patients were not cured. From 1990 to the present large collaborative networks have provided studies were not possible heretofore. Randomized controlled trials captured and manipulated vast amounts of data, banked biological specimens and shared these resources and intellectual capital, moving the field forward at an extraordinary pace. We now know that even for severe forms of granulomatosis and polyangiitis [granulomatosis with polyangiitis (GPA), Wegener's granulomatosus (WG)], microscopic polyangiitis (MPA) and Churg-Strauss syndrome (CSS), we do not need to use CyP for extended periods. We have learned recently that rituximab is as effective as CyP for severe WG and MPA. We should never again see the permanent toxicities born from years of chronic CyP use. However, short courses of CyP remain useful and can be life-saving. Step-down therapy from CyP is now a standard of care, perhaps to be replaced by rituximab in the future. If one accepts the premise that there are few cures at present for idiopathic large- and small-vessel vasculitis, we will serve our patients well if we can determine the most effective initial therapy that leads to a maintenance strategy for remission with least risk. Ultimately, we wish to identify causes of vasculitis so they can be used as a wedge to secure cures. Unmet needs and strategies are as follows: (1) to increase the numbers of vasculitis-trained physicians; (2) to define risk-benefit formulae for chronic maintenance therapy versus discontinuation of treatment after remission; (3) to define risk- and cost-benefit formulae for laboratory monitoring; (4) large-scale studies with longer follow-up that explore inhibition of interleukin-5 in CSS; (5) to explore the value of anti-interferon-γ for GCA, Takayasu's and other granulomatous vasculitides; and (6) identification of aetiological factors: cures will probably be linked to knowledge of the antigen driving the disease, plus vulnerabilities of the patient that prepare them to develop an illness phenotype. Improved outcomes using anti-inflammatory/immunosuppressive agents do not rule out infection as a driver for autoimmunity. Techniques that can facilitate pathogen discovery have never been more sophisticated.
journal_name
Clin Exp Immunoljournal_title
Clinical and experimental immunologyauthors
Hoffman GSdoi
10.1111/j.1365-2249.2011.04365.xsubject
Has Abstractpub_date
2011-05-01 00:00:00pages
35-8eissn
0009-9104issn
1365-2249journal_volume
164 Suppl 1pub_type
历史文章,杂志文章,评审abstract::Supernatants of concanavalin A (Con A)-activated human spleen cells have been previously shown to inhibit polyclonal immunoglobulin (Ig) biosynthesis by pokeweed mitogen (PWM)-stimulated human spleen and peripheral blood mononuclear cells. In the present study, hydrocortisone was added at the beginning of in vitro cul...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:
更新日期:1982-04-01 00:00:00
abstract::The diagnostic value of the determination of the relative distribution of B (SmIg-positive) and T (E rosetting) cells in the blood and in pleural or ascitic effusions was evaluated in 10 patients with tuberculosis and in six with malignant diseases. A higher percentage of T and a lower percentage of B lymphocytes in s...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:
更新日期:1981-07-01 00:00:00
abstract::Churg-Strauss syndrome (CSS) is a rare form of systemic vasculitis occurring in patients with asthma and hypereosinophilia; however, its mechanisms involved in the severe tissue inflammation with vasculitis are poorly understood. High mobility group box 1 (HMGB1) protein, originally identified as a DNA binding protein...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章,收录出版
doi:10.1111/j.1365-2249.2007.03347.x
更新日期:2007-05-01 00:00:00
abstract::Serum IgG-antilipoprotein-autoantibody activity (at 4 degrees C) of a plane xanthoma patient was shown by double-immunodiffusion method. Cryoglobulins in the serum were dissociated to polyclonal IgG and alpha- and beta-lipoproteins by acidification and were reconstructed by neutralization. IgG fraction of the cryoglob...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:
更新日期:1977-06-01 00:00:00
abstract::C3b-coated immune complexes adhere to the complement receptor 1 (CR1, CD35) on human erythrocytes. This multi-valent binding might be favoured by the known clustering of CR1 and by the multiple C3b-binding sites on each CR1. The size of the CR1 clusters correlates directly with the number of CR1/erythrocytes, and the ...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1111/j.1365-2249.1991.tb08116.x
更新日期:1991-04-01 00:00:00
abstract::Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of autoimmune diseases, including granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). It is not known why ANCA develop, but it has been shown that they participate in pathogenesis by activating polymorphonuclear n...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1111/j.1365-2249.2012.04633.x
更新日期:2012-10-01 00:00:00
abstract::During the past decade several notable viruses have suddenly emerged from obscurity or anonymity to become serious global health threats, provoking concern regarding their sustained epidemic transmission in immunologically naive human populations. With each new threat comes the call for rapid vaccine development. Inde...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章,评审
doi:10.1111/cei.13295
更新日期:2019-05-01 00:00:00
abstract::Recent evidence has suggested that IgA1-containing macromolecules and the glycosylation of IgA1 in sera from patients with IgAN might involve the pathogenesis of IgAN. However, whether the different histological phenotypes can be attributed or not to the aberrant glycosylation of macromolecular IgA1 has not yet been e...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1111/j.1365-2249.2005.02949.x
更新日期:2005-12-01 00:00:00
abstract::The programmed death-1 (PD-1) receptor ligands, PD-L1 and PD-L2, are co-stimulatory molecules that contribute to the negative regulation of T lymphocyte activation. It is still unclear whether there is correlation between PD-L1 or PD-L2 and tumour-infiltrating dendritic cells (TIDCs) in cutaneous squamous cell carcino...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1111/cei.12921
更新日期:2017-06-01 00:00:00
abstract::Four human B cell lines with a mature phenotype (immunoglobulin secretion and expression of membrane markers associated with maturation) were cultured in the presence of phorbol ester (PMA), dimethyl sulphoxide (DMSO) and two conditioned media. PMA and DMSO led to changes in phenotype which suggested the cells were be...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract::Bullous pemphigoid is a blistering skin disease characterized by autoantibodies against the NC16a domain of bullous pemphigoid 180. This study was performed to characterize and map the fine specificity of T cell responses to NC16a. Peripheral blood mononuclear cells (PBMC) from a total of 28 bullous pemphigoid patient...
journal_title:Clinical and experimental immunology
pub_type: 临床试验,杂志文章
doi:10.1111/cei.12566
更新日期:2015-05-01 00:00:00
abstract::It is suggested that CD30 and CD26 are surface molecules expressed on activated Th2 and Th1 cells, respectively. We examined plasma levels of soluble CD26 (sCD26) and sCD30 in patients with atopic dermatitis (AD) when their eruptions were aggravated and in non-atopic healthy controls, and then analysed the possible co...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1046/j.1365-2249.2000.01286.x
更新日期:2000-08-01 00:00:00
abstract::Th1 cell-induced anti-mycobacterial immunity is lost during a progressive Mycobacterium tuberculosis infection in a susceptible host. This study was designed to test the mechanism of the loss of anti-mycobacterial cell-mediated immune response. We demonstrate that M. tuberculosis infection results in increased Fas exp...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1046/j.1365-2249.1999.00755.x
更新日期:1999-02-01 00:00:00
abstract::Anti-idiotypic antibodies (anti-Id Abs) are involved in the regulation of a number of immune responses including the IgE antibody production. In atopic patients, the increased synthesis of IgE antibodies could be related to a defective production of regulatory anti-Id Abs. In the present study, we first developed a se...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1111/j.1365-2249.1990.tb03303.x
更新日期:1990-06-01 00:00:00
abstract::The effector arm of the mucosal immune system comprises lymphocytes scattered at intraepithelial and lamina propria levels. Intraepithelial lymphocytes (IEL) are a large population of oligoclonal resting cells which exhibit phenotypic and functional characteristics of cytolytic T cells when activated. Several mechanis...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1046/j.1365-2249.2000.01200.x
更新日期:2000-05-01 00:00:00
abstract::The induction of immunoregulatory cytokines IL-1 beta, IL-6, IL-12, tumour necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) was studied with neonatal (cord blood) monocyte-derived macrophages (MDM) after in vitro infection with respiratory syncytial virus (RSV). The expression of mRNAs for these cyto...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1046/j.1365-2249.1996.d01-874.x
更新日期:1996-12-01 00:00:00
abstract::An injection of human renal tubular fraction, Fx1A, with Freund's complete adjuvant in rats induces Heymann nephritis (HN) with clinical and morphological features similar to rat Fx1A-induced HN. The present study was undertaken to characterize antibody specificities and the corresponding antigen involved in human Fx1...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:
更新日期:1987-07-01 00:00:00
abstract::Serum from patients suffering from the autoimmune skin disease pemphigus vulgaris has been used to demonstrate the presence of intercellular substance (ICS) on the surface of these chistosomula of Schistosoma mansoni which has penetrated mouse skin in vitro or during a percutaneous infection. ICS was absent from mecha...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:
更新日期:1979-06-01 00:00:00
abstract::The guinea pig model of low-dose pulmonary tuberculosis has been used to study the pathogenesis of infection as well as the mechanisms of bacille Calmette-Guérin (BCG) vaccine-induced resistance. We investigated the function of lung cells from naive and BCG-vaccinated guinea pigs after enzymatic digestion of lung tiss...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1111/j.1365-2249.2007.03425.x
更新日期:2007-08-01 00:00:00
abstract::We have investigated TNF-alpha secretory response of peripheral blood mononuclear cells (PBMC) from 13 uraemic patients undergoing regular haemodialysis with cuprophane membrane (CM). Sixteen healthy subjects and five uraemic patients under conservative therapy were also studied as controls. Cells of haemodialysis pat...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1111/j.1365-2249.1992.tb05830.x
更新日期:1992-10-01 00:00:00
abstract::Low-density cells (LDC) of dendritic morphology from the blood of patients with common variable (late-onset) hypogammaglobulinaemia (CVH) did not induce allogeneic immunoglobulin production by normal B cells unlike LDC from normal blood. When LDC from patients were treated with pokeweed mitogen (PWM), a lower allogene...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:
更新日期:1985-07-01 00:00:00
abstract::Lidocaine, bupivacaine or ropivacaine are used routinely to manage perioperative pain. Sparse data exist evaluating the effects of local anaesthetics (LA) on fibroblasts, which are involved actively in wound healing. Therefore, we investigated the effects of the three LA to assess the survival, viability and prolifera...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1111/j.1365-2249.2010.04252.x
更新日期:2010-11-01 00:00:00
abstract::Human neutrophils, added to fibronectin (FN)-coated polystyrene wells and exposed to tumour necrosis factor-alpha (TNF-alpha), were found to exhibit a prolonged production of superoxide anion (O2-) after a lag period of approx 30 min. The O2- production, but not the cell adherence to FN, was completely inhibited by tw...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1111/j.1365-2249.1993.tb08230.x
更新日期:1993-12-01 00:00:00
abstract::There are estimated to be approximately 1500 people in the United Kingdom with C1 inhibitor (C1INH) deficiency. At BartsHealth National Health Service (NHS) Trust we manage 133 patients with this condition and we believe that this represents one of the largest cohorts in the United Kingdom. C1INH deficiency may be her...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1111/cei.12083
更新日期:2013-07-01 00:00:00
abstract::A method has been developed for separating eosinophils from other types of leucocyte in normal individuals. Erythrocytes are sedimented with dextran, and mononuclear cells are removed on an isotonic density gradient of ficoll and sodium diatrizoate. The eosinophils and neutrophils are then washed and sedimented onto p...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:
更新日期:1977-05-01 00:00:00
abstract::An altered expression pattern of adhesion molecules (AM) on the surface of immune cells is a premise for their extravasation into the central nervous system (CNS) and the formation of acute brain lesions in multiple sclerosis (MS). We evaluated the impact of glatiramer acetate (GA) on cell-bound and soluble AM in the ...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1111/cei.12125
更新日期:2013-09-01 00:00:00
abstract::In order to define the optimal conditions for detection of microbial antigens in urine, urinary HBsAg excreted during hepatitis B was chosen as a model. Using commercial kits, which mainly involve anti-discontinuous epitopes, we found urinary HBsAg in only 50% of patients with HBsAg in their sera. In contrast, with an...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1111/j.1365-2249.1992.tb02991.x
更新日期:1992-02-01 00:00:00
abstract::The prolonged generalized lymphadenopathy syndrome (PGL) has been considered a prodromal condition to the Acquired immunodeficiency syndrome (AIDS), but the clinical, virological and immunological characteristics of patients who will develop AIDS are not known. We report on the immunological profile of intravenous dru...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract::IL-5 is a major factor inducing differentiation of B lymphocytes into immunoglobulin-producing cells as well as a main regulator of eosinophils. Recently, we have shown that peripheral blood mononuclear cells (PBMC) from patients with alveolar echinococcosis (AE) express IL-5 mRNA after stimulation with crude Echinoco...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:10.1046/j.1365-2249.1997.4031299.x
更新日期:1997-07-01 00:00:00
abstract::Depletion of monocytes from peripheral blood mononuclear cells of patients with systemic lupus erythematosus (SLE) resulted in a decreased anti-DNA antibody synthesis in vitro. The addition of monocytes restored the response by lymphocytes and the maximum response in the presence of 2.5-8% of monocytes, whereas greate...
journal_title:Clinical and experimental immunology
pub_type: 杂志文章
doi:
更新日期:1989-07-01 00:00:00